First Uterus Transplant Planned in the U.S.

The Cleveland Clinic is one step closer to performing the first uterus transplantation in the United States. Uterus transplantation is performed on a woman without a uterus who would like to become pregnant and give birth to a child. Sweden has performed nine uterine transplantations; four of the women gave birth and two transplants were unsuccessful. Saudi Arabia and Turkey have attempted uterine transplantations as well, but both were unsuccessful.

Strict protocols have been implemented regarding this transplantation. Unlike Sweden which allows transplantation from live donors, the transplantations in the United States are from deceased organ donors. Recipients of the transplantation must be in a stable relationship and have ovaries. They will be screened for psychological disorders and interviewed to make sure they are not being pressured into the transplantation. Since the uterus will not be connected to the recipient’s fallopian tubes, fertilization must be completed through in-vitro fertilization. Babies will only be delivered through caesarian section. Before, during and after pregnancy, the woman will have to take anti-rejection medication. The uterus will be removed from the recipient surgically after she has had one or two children so that she can discontinue anti-rejection drugs.

There are ethical concerns regarding the transplantation of reproductive tissue. Bioethicists and others have asked whether the deceased would want her organ used for reproductive purposes and how to prioritize the recipients of reproductive tissue since those receiving uteri for reproductive purposes are not in life-threatening circumstances. Nevertheless, Cleveland Clinic’s fifteen-member ethics board approved the experimental uterus transplantation. Additionally, other medical ethicists have stated that they do not find anything ethically wrong with the procedure. The first candidate to undergo the procedure is aware of the transplantation and pregnancy risks and has begun hormone treatments as she prepares for the procedure.

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The pieces here represent the position and analysis of the individual authors and not those of the Hofstra Bioethics Center or The Gitenstein Institute for Health Law & Policy. Each author is responsible for the accuracy of the citations and substance of the text itself.